两种血细胞分离机干/祖细胞采集和移植效果的比较

背景:外周血造血干/祖细胞通过血细胞分离机进行体外收集,血细胞分离机的性能、工作状况将直接关系到采集物的特性和数量,从而直接影响受者的造血重建.目的:比较Fenwal CS-3000 Plus与Amicus两种血细胞分离机采集外周血造血干/祖细胞及受者移植效果.方法:共入选接受异基因外周血干细胞移植患者51例,Fenwal CS-3000 Plus组27例,平均年龄(34.2±10.6)岁;Amicus组24例,平均年龄(35.4±12.1)岁.比较两组采集物有核细胞数、CD34+细胞数、采集效率、红细胞与血小板采集量及造血重建时间.结果与结论:两组采集物的有核细胞数、CD34+细胞数、采集效率、红细胞采集量及造血重建时间差异均无显著性意义;Fenwal CS-3000Plus组血小板采集量明显高于Amicus组(P<0.01).结果显示Fenwal CS-3000 Plus与Amicus血细胞分离机在分离外周血干/祖细胞方面和移植效果没有差异;血小板较低被采集者使用Amicus血细胞分离机采集可能更为安全.     

Cobe Spectra与Fenwal CS 3000 Plus血细胞分离器外周血造血干/祖细胞的采集效能比较

为了评价Cobe Spectra(Version6.1)和Fenwal CS 3000 Plus两种血细胞分离机在造血干／祖细胞采集中的采集效能，对36人64次外周血造血干／祖细胞的采集进行了回顾性分析．20人42次使用Cobe Spectra采集，16人22次使用Fenwal CS 3000 Plus采集对CD34^ 细胞采集量、采集效率以及红细胞与血小板的采集量进行比较，结果表明：Cobe Spectra和Fenwal CS 3000 Plus在CD34^ 细胞采集量和采集效率上无显著差异?CD34^ 细胞采集量与供者白细胞、单核细胞、造血祖细胞、CD34^ 细胞的动员情况呈正相关，在多因素stepwise线性回归模型中，采集前外周血干／祖细胞浓度是唯一有意义的影响因素，Fenwal CS 3000 Plus的采集效率与外周血单核细胞量呈负相关。Fenwal CS 3000 Plus对红细胞的收集量显著高于Cobe Spectra，并且采集后供者外周血血小板降低程度较Cobe Spectra更严重。结论：Cobe Spectra(Version 6．1)和Fenwal CS 3000 Plus在CD34^ 细胞的采集能力上无显著差别。当外周血单核细胞数量高，或是血型不合移植的及血小板减少的供者，推荐使用Cobe Spectra血细胞分离机.     

两种血细胞分离机干/祖细胞采集效果及供者采集前后血液指标变化的比较

目的比较Fenwal CS-3000 Plus(以下简名称Fenwal)与Amicus 2种血细胞分离机分离外周血造血干/祖细胞的效果及干/祖细胞采集后供者血液指标的变化。方法共有56名供者入组,Fenwal组32名,年龄(36.2±11.6)岁,选择单个核细胞采集程序,共循环37次;Amicus组24名,年龄(35.4±12.1)岁,选择MNC采集程序共循环27次。比较2组采集物白细胞总数、单个核细胞百分率、CD34+细胞数及采集前后供者Hct、Plt的变化。结果2组采集物的白细胞数、单个核细胞百分率、CD34+细胞数、采集效率均差异无统计学意义;2组采集后供者Plt下降率Fenwal组供者较Amicus组高;2组采集后供者Hct下降率差异无统计学意义;2组采集物中MNC、CD34+细胞数均与外周血中MNC呈正相关,CD34+细胞百分率与外周血MNC无相关性。结论在分离外周血干/祖细胞方面Fenwal与Amicus没有明显差异。     

Amicus与CS-3000血细胞分离机采集外周血造血干细胞效果比较

目的 探讨Amicus与CS-3000血细胞分离机采集外周血造血干细胞的效果.方法 供者均给予G-CSF动员,分别采用Amicus血细胞分离机的MNC程序和CS-3000血细胞分离机的单个核细胞程序采集供者外周血干细胞;用流式细胞仪检测所采集干细胞的CD34+细胞数.供者52例,共采集62次,其中Amicus血细胞分离...     

ABO血型不合供者外周血造血干细胞的采集及移植效果研究

目的探讨应用CS-3000 Plus血细胞分离机采集ABO血型不合供者外周血造血干细胞的效率及不去除红细胞和/或血浆进行异基因外周血造血干细胞移植(PBSCT)的安全性。方法经G-CSF 5μg/(kg.d)动员的异基因外周血干细胞供者33名,应用CS-3000 Plus血细胞分离机的干细胞采集程序于动员后d 5采集,其中ABO血型主要不合12名,次要不合8名以及ABO血型相合13名。根据供者外周血的红细胞压积(Hct)和单个核细胞(MNC)计数,对分离机参数作相应调整。输注前从产品袋中留取干细胞,检测有核细胞数、MNC比例、CD34+细胞数、红细胞、血浆含量。单次处理循环血量(9 986±2 489)ml,抗凝剂用量(971±162)ml。供者采集前注射10%葡萄糖酸钙,以预防低钙反应。观察PBSC输注后受者的生命体征、尿液颜色及是否有溶血相关不良反应等。结果ABO血型主要不合组、次要不合组与ABO血型相合组采集物中的有核细胞数、CD34+细胞数、MNC比例无统计学差异(P>0.05),3组供者每次采集的PBSC产品终体积近60 ml,ABO主要不合组采集物中混入红细胞为(3.67—10.25)×1010/袋,ABO次要不合组采集物中血浆量为22—38 ml,不去除红细胞及血浆,直接回输给受者,均未出现溶血反应,所有患者造血功能均获得重建。结论应用CS-3000 Plus血细胞分离机采集ABO血型不合供者的外周血干细胞,通过调整分离机参数,减少ABO血型不合红细胞的混入,可以获得足够的干细胞数量并安全用于移植。     

ABO血型不合供者外周血造血干细胞的采集

目的研究ABO血型不合供者外周血造血干细胞的采集方法,探讨不去除红细胞和/或血浆进行造血干细胞移植的安全性。方法 29例异基因外周血干细胞移植供者与受者HLA配型为全相合或1～3位点不合,其中ABO主要不合13例,次要不合7例,ABO血型相合9例。采用CS-3000Plus血细胞分离机的干细胞采集程序对ABO血型不合供者的外周血造血干细胞进行采集,不去除红细胞和/或血浆,直接回输给受者。结果 ABO血型主要不合、次要不合及血型相合的供者每次采集的外周血干细胞(PBSC)产品终体积为(59.11±1.19)ml,单个核细胞(MNC)采集物、MNC比例、CD34+细胞、RBC含量三组间的差异无统计学意义。结论应用CS-3000Plus血细胞分离机采集ABO血型不合供者外周血造血干细胞,不仅对供者安全,而且采集产品中造血干细胞浓度较高,血型不合的红细胞污染较少,不需要去除红细胞和血浆,可安全地用于ABO血型不合的受者。     

2种血细胞分离机外周血干细胞采集效率的比较

目的 比较CS-3000 plus和COM.TEC血细胞分离机采集外周造血干细胞的效率.方法 56例检测标本均来自本院2011年自体外周血干细胞移植患者或异基因移植供者,其中CS-3000血细胞分离机采集33例,COM.TEC血细胞分离机采集23例.比较2组采集前供/患者的白细胞计数、红细胞压积;产品中白细胞数、单个核细胞比例、体外总循环量、产品体积、产品中MNC(单个核细胞总数)及单位循环量MNC、CD34+细胞总数及单位循环量CD34+.结果 CS-3000 plus与COM.TEC血细胞分离机采集产品中单个核细胞的比例有一定差异(P＜0.05),CS-3000 plus中单个核细胞比例高于COM.TEC血细胞分离机;CS-3000 plus产品体积显著小于COM.TEC 血细胞分离机产品体积(P＜0.05);按照单位循环量采集的细胞数,无论是以MNC还是CD34+细胞计算,2种机器采集效率的差异无统计学意义(P＞0.05),提示2种血细胞分离机均可采集足够的造血干细胞.结论 CS-3000plus和COM.TEC血细胞分离机在单个核细胞采集效率和CD34+细胞采集效率的差异无统计学意义.     

供者血细胞比容对机采血小板产品计数和收集效率的影响

为提高机采血小板制品的质量，保证临床输血的有效性，人们对血细胞分离机的自动化程度、操作程序以及制品质量等方面不断改进。Fenwal Amicus血细胞分离机是CS-3000plus的换代机型，笔者使用Amicus血细胞分离机采集供者血小板102例，以探讨供者血细胞比容对本机型采集产品的血小板计数、收集效率的影响。     

外周造血干/祖细胞采集的护理

目的 保证患者及健康捐献者外周造血干/祖细胞采集的顺利完成,确保达到造血干/祖细胞移植所需量.方法 用CS-3000Plus血细胞分离机对14例患者及14例健康捐献者进行外周血干/祖细胞采集,并在采集前、中、后实施观察及护理.结果 28例中静脉置管9例,静脉穿刺19例,经过1～2次采集,采集量达到造血干/祖细胞移植所需量.无1例出现呼吸循环功能不全.结论 采集时血管的选择及悉心护理保证了外周造血干/祖细胞采集的足量和质量.     

应用CS-3000 Plus血细胞分离机采集血型不合供者的外周血干细胞的临床研究

[目的]探讨应用CS-3000 Plus血细胞分离机采集ABO及Rh血型不合的供者外周血干细胞(PBSC)的得率及不去除红细胞或血浆用于异基因外周血干细胞移植的可行性.[方法]采用CS-3000 Plus血细胞分离机的自动干细胞采集程序对14例异基因外周血干细胞供者进行采集,其中ABO血型主要不合5例,次要不合6例,主要次要均不合2例,Rh血型主要不合1例.供者循环收集的细胞成分按供者外周血的红细胞比容(HCT)和单个核细胞(MNC)计数作相应调整.输注前从产品袋中留取标本检查有核细胞计数、MNC比例、CD34 细胞计数和台盼蓝拒染率.回输时对受者采取使用糖皮质激素、水化、碱化、利尿等保护措施.[结果]供者均经2～3次采集收集到足够的有核细胞直接回输给受者.共采集PBSC 30次,平均每次获得有核细胞5.65×1010,单个核细胞占96%～98%.CD34 细胞数平均为6.52×106/kg,细胞拒染率均为100%.ABO血型主要不合、主要、次要均不合及Rh主要血型不合的供者每次采集的PBSC产品终体积均为50 ml,产品中含压积红细胞3～7 ml,ABO血型次要不合供者每次采集的PBSC产品中含血浆15～25 ml,不去除红细胞及血浆,直接回输给受者,无一例出现溶血性输血反应,造血均获得重建.[结论]采用CS-3000Plus血细胞分离机,通过调整参数采集血型不合供者的外周血干细胞,减少血型不合的红细胞,可以获得足够的干细胞数量并安全用于移植.     

两种血细胞分离机分离外周血造血干细胞效果比较

目的　比较FenwalCS 3000plus及CobeSpectra两种血细胞分离机分离外周血造血干细胞的效果。方 法　共有76名供者入组。FenwalCS 3000plus组31例,平均年龄(39.1±12.9)岁,共循环38次;CobeSpectra组 45例,平均年龄(38.2±11.2)岁,共循环65次。比较两组采集物白细胞总数、单核细胞百分率、采集物单核细胞中 CD34+细胞百分率。结果　两组采集物的白细胞计数无明显统计学差异;FenwalCS 3000plus组单核细胞百分率 高于CobeSpectra组。两组采集物中CD34+细胞百分率无明显统计学差异。CobeSpectra组采集物中单核细胞百 分率与白细胞数负相关。两组单核细胞百分率、两组白细胞数均与CD34细胞百分率无相关性。结论　本组资料 显示在分离外周血干细胞方面FenwalCS 3000plus与CobeSpectra之间没有差异。     

In vitro collection and posttransfusion engraftment characteristics of MNCs obtained by using a new separator for autologous PBPC transplantation

BACKGROUND: A clinical study was performed to evaluate the peripheral blood progenitor cell (PBPC) collection, transfusion, and engraftment characteristics associated with use of a blood cell separator (Amicus, Baxter Healthcare). STUDY DESIGN AND METHODS: Oncology patients (n = 31) scheduled for an autologous PBPC transplant following myeloablative therapy were studied. PBPCs were mobilized by a variety of chemotherapeutic regimens and the use of G-CSF. As no prior studies evaluated whether PBPCs collected on the Amicus separator would be viable after transfusion, to ensure patient safety, PBPCs were first collected on another cell separator (CS-3000 Plus, Baxter) and stored as backup. The day after the CS-3000 Plus collections were completed, PBPC collections intended for transfusion were performed using the Amicus instrument. For each transplant, >2.5 x 10(6) CD34+ PBPCs per kg of body weight were transfused. RESULTS: Clinical data collected on the donors immediately before and after PBPC collection with the Amicus device were comparable to donor data similarly obtained for the CS-3000 Plus collections. While the number of CD34+ cells and the RBC volume in the collected products were equivalent for the two devices, the platelet content of the Amicus collections was significantly lower than that of the CS-3000 Plus collections (4.35 x 10(10) platelets/bag vs. 6.61 x 10(10) platelets/bag, p<0.05). Collection efficiencies for CD34+ cells were 64 +/- 23 percent for the Amicus device and 43 +/- 14 percent for the CS-3000 Plus device (p<0.05). The mean time to engraftment for cells collected via the Amicus device was 8.7 +/- 0.7 days for >500 PMNs per microL and 9.7 +/- 1.5 days to attain a platelet count of >20,000 per microL-equivalent to data in the literature. No CS-3000 Plus backup cells were transfused and no serious adverse events attributable to the Amicus device were encountered. CONCLUSIONS: The mean Amicus CD34+ cell collection efficiency was better (p<0.05) than that of the CS-3000 Plus collection. Short-term engraftment was durable. The PBPCs collected with the Amicus separator are safe and effective for use for autologous transplant patients requiring PBPC rescue from high-dose myeloablative chemotherapy.     

Ex vivo evaluation of PBMNCs collected with a new cell separator

BACKGROUND: This study reports on an evaluation of the ability of a cell separator (Amicus, Baxter Healthcare) and the integral MNC computer software program to collect a variety of MNC subsets. The collection efficiency (CE) of the Amicus for these MNC subsets was compared to that of another cell separator (CS-3000 Plus, Baxter). The collected MNCs were also assayed ex vivo to determine if these cells remained functional. STUDY DESIGN AND METHODS: Healthy volunteer blood donors were recruited to provide PBMNCs for the isolation of CD3+, CD4+, CD8+, CD19+, NK, and gammadelta+ cells and monocytes. Cells were collected with an Amicus (test arm; n = 16) or a CS-3000 Plus (control arm; n = 11) cell separator. Cells were counted on a flow cytometer and CEs were calculated. For functional studies, the Amicus-collected MNC data were compared to CS-3000 Plus historical data. Functional studies performed included surface antigen expression assays (CD8+), proliferation assays (CD4+ and CD8+ cells), NK cytotoxicity assays for K562 and HUVE cells, and E-selectin induction on endothelial cells through NK+ contact dependency. Dendritic cells (DCs) were generated from CD34+ cells collected on the Amicus, positively selected by the use of antibody-bound, magnetic bead technology, and then cultured ex vivo with a combination of growth factors to generate the DCs. RESULTS: CEs were higher on the Amicus than on the CS-3000 Plus for CD3+ (68 vs. 54%), CD4+ (70 vs. 56%), CD8+ (68 vs. 52%), and CD19+ (60 vs. 48%) cells (p<0.05). For the two separators, CEs were equivalent for monocytes, NK+, and gammadelta+ cells. The Amicus separator collected significantly fewer platelets than did the CS-3000 Plus (p<0.00001). CD4+, CD8+, and NK cells proliferated normally. NK cells appropriately stimulated E-selectin expression on endothelial cells. Culture-generated DCs obtained by using Amicus-collected CD34+ cells expressed appropriate cell surface markers. CONCLUSION: The Amicus separator is acceptable for the collection of PBMNC subsets. The device collects CD3+, CD4+, CD8+, and CD19+ T- and B-cell subsets with greater efficiency and collects MNCs with significantly fewer contaminating platelets than does the CS-3000 Plus. Cells collected on the Amicus are suitable for use in a variety of research and clinical immunobiologic studies.     

三种不同型号的血细胞分离机在采集外周血单个核细胞中的应用分析

本研究比较3种血细胞分离机采集外周血单个核细胞（MNC）的效果及患者血液相关指标的变化.应用CS-3000plus、MCSplus和COBE spectras3种血细胞分离机采集94例肿瘤患者的外周血单个核细胞,进行患者单采前后血常规及终产品血常规检测;瑞氏染色后,人工计数MNC;检测单采前后患者外周血CD3,CD4,CD8细胞百分比.结果表明,三组采集的MNC数（×109/袋）分别为3.08±0.79,3.21±1.12和3.22±1.84;Ph下降百分比分别为（6.86±5.70）％,（8.05±5.14）％和（5.89±4.48）％,三组患者治疗前后外周血CD3、CD4和CD8细胞百分比的比较差异有统计学意义（P值均＜0.001）.结论：应用3种血细胞分离机均可采集到足够量的MNC,满足了培养的要求,同时也满足了临床治疗的要求.     

Comparison of CD34+ cell collection on the CS-3000+ and Amicus blood cell separators

BACKGROUND: Mobilized PBPCs, detectable on the basis of CD34 expression, can be collected on various cell separators. The CD34+ cell collection efficiencies of two cell separators (CS-3000+ and Amicus, Baxter) were tested on two comparable groups of oncology patients. STUDY DESIGN AND METHODS: Leukapheresis assisted by the standard manufacturer's software and variables settings was performed in 37 (CS-3000+) and 34 (Amicus) patients (total of 83 and 67 collections, respectively) after chemotherapy plus G-CSF treatment. RESULTS: The total CD34+ cell count per leukapheresis components as well as per kg of patient's body weight were twofold higher by using the Amicus than the CS-3000+ device. Platelet contamination in Amicus components was twice as low compared to the CS3000+. Mean Amicus CD34+ collection efficiency (CD34+eff) (54.9 +/- 27.2%) was significantly higher (p < 0.015) than the CS-3000+ (46.4 +/- 16.7%) one. However, Amicus CD34+eff decreased progressively as the peripheral blood CD34+ concentrations increases over 200 CD34+ cells per microL. A parallel increase in the WBC counts in these cases seems to be the principal cause of decrease in CD34+eff (evident for WBCs >40 x 10(3)/microL and most pronounced for WBCs >60 x 10(3)/microL). CONCLUSIONS: Mean CD34+eff and CD34+ cell yields were better on Amicus than on CS-3000+. CD34+eff of Amicus, however, seems to be related to the initial WBC counts, decreasing progressively when WBC increased over 4 x 10(3) per microL that coincided with the increase in CD34+ cell concentrations. For these cases, the volume and duration of cycles should be adapted to optimize CD34+ collections by using Amicus separators.     

Peripheral blood stem cell collection in a patient with chronic myelogenous leukemia and a high circulating nucleated red cell fraction

A high level of circulating nucleated red blood cells (NRBC) in patients with chronic myeloproliferative syndromes could potentially complicate peripheral blood stem cell (PSC) collection. The mononuclear NRBC might comprise a significant fraction of the total mononuclear cells in the final product. We report a successful PSC collection in a patient with more NRBC than WBC in the peripheral blood. A 27-year-old man with chronic myelogenous leukemia underwent eight PSC collection procedures, seven using the Cobe Spectra (Spectra) and one using the Fenwal CS3000 Plus (CS). PSC product manipulations to remove NRBC were unnecessary. As assessed by post-collection NRBC:WBC ratio as a percent of the initial ratio, Spectra selectively harvested mononuclear leukocytes over NRBC. The collected products had a mean NRBC:WBC ratio that was 3.4% of the peripheral blood ratio. Adequate numbers of mononuclear leukocytes were collected with less than 6% NRBC contamination. The single CS procedure resulted in a comparable NRBC reduction efficiency as the Spectra. We conclude that PSC harvest using automated blood cell separators from patients with a high level of circulating NRBC may result in a product with an acceptable number of NRBC.     

无关供者24例外周血干细胞动员和采集

目的 总结无关供者外周血千细胞(PBSC)动员和采集情况.方法 24例无关供者给予重组人粒细胞集落刺激因子(rhG-CSF)5 μμg·kg-1·d-1,每天皮下注射,第4、5天或5、6天用CS-3000PLUS血细胞分离机采集外周血干细胞,计数采集物中单个核细胞(MNC)和CD34+细胞.结果 所有供者均安全顺利完成...